Clinical Trial Patient Recruitment & Eligibility Survey
About this free form template

Finding qualified, informed participants is one of the biggest challenges in clinical research. This Clinical Trial Patient Recruitment & Eligibility Survey streamlines the screening process by combining eligibility criteria, consent comprehension checks, and trial expectations into one professional form that respects both research integrity and patient understanding.

Designed for clinical research organizations, hospital research departments, pharmaceutical companies, and contract research organizations (CROs), this template helps research coordinators identify suitable candidates while ensuring participants truly understand what they're signing up for. The form walks potential participants through key eligibility questions, tests their comprehension of informed consent concepts, explains trial phases, and confirms their acceptance of potential placebo assignment—all critical elements of ethical research recruitment.

The multi-page structure creates a natural progression from basic demographics through medical history, lifestyle factors, and finally to trial-specific understanding. Conditional logic ensures you only ask relevant follow-up questions based on initial responses, making the experience more personalized and less overwhelming for potential participants. This approach not only improves completion rates but also helps you identify the most suitable candidates faster.

With Paperform's calculation fields and conditional workflows, you can automatically score eligibility based on responses and route qualified candidates to the next stage of your recruitment process. Connect the form to your CRM or research management system to keep participant data organized and compliant. For studies requiring formal consent documentation, integrate with Papersign to send consent forms for eSignature once eligibility is confirmed, creating a complete digital audit trail from initial interest to enrolled participant.

Whether you're recruiting for Phase I safety studies, Phase III efficacy trials, or post-market surveillance research, this template provides a solid foundation that can be customized to your specific protocol requirements while maintaining the professional, trustworthy presentation that participants expect from legitimate medical research.

Built for growing businesses, trusted by bigger ones.
Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.

More templates like this

Clinical Research Study Participant Satisfaction Survey

Clinical Research Study Participant Satisfaction Survey

Gather valuable feedback from clinical trial participants on their experience with study protocols, informed consent processes, adverse event reporting, and trial coordinator communication to improve research quality and participant care.

Community Health Needs Assessment Survey

Community Health Needs Assessment Survey

A comprehensive community health needs assessment form to identify health priorities, access barriers, social determinants of health, and gather feedback for program improvement.

Addiction Recovery Program Research Survey

Addiction Recovery Program Research Survey

A comprehensive market research survey designed to understand treatment modality preferences, support group interests, aftercare needs, and accessibility requirements for addiction recovery programs.

Advanced Access Scheduling Patient Survey

Advanced Access Scheduling Patient Survey

Measure patient satisfaction with same-day appointment availability, scheduling ease, wait times, and provider continuity to improve your advanced access scheduling system.

Bipolar Disorder Medication Adherence Research Study Registration

Bipolar Disorder Medication Adherence Research Study Registration

A comprehensive registration form for participants joining a bipolar disorder medication adherence research study, including consent for mood tracking, pharmacogenetic testing, digital monitoring, and hospitalization prevention planning.

CAHPS Clinician & Group Survey - Patient Experience Quality Reporting

CAHPS Clinician & Group Survey - Patient Experience Quality Reporting

A comprehensive CAHPS survey form for medical practices to collect standardized patient experience data for insurance and quality reporting requirements.

Celiac Disease Gluten Challenge Research Enrollment Form

Celiac Disease Gluten Challenge Research Enrollment Form

A comprehensive enrollment form for celiac disease research studies involving gluten challenge protocols, with consent sections for antibody testing, endoscopy procedures, symptom monitoring, and strict follow-up requirements.

Clinical Study Recruitment Age Verification & Health Screening

Clinical Study Recruitment Age Verification & Health Screening

Screen and verify potential clinical study participants with age verification, comprehensive health screening questions, and informed consent documentation.

Clinical Trial Enrollment Checkout Form

Clinical Trial Enrollment Checkout Form

Complete clinical trial enrollment form with eligibility screening, informed consent, appointment scheduling, and compensation details. Streamline your research participant enrollment process.

Clinical Trial Participant Age Verification & Eligibility Screening

Clinical Trial Participant Age Verification & Eligibility Screening

Verify participant age and eligibility for clinical trials with integrated consent forms and HIPAA authorization for compliant healthcare research enrollment.

Clinical Trial Participant Emergency Contact Form

Clinical Trial Participant Emergency Contact Form

A comprehensive emergency contact form for clinical trial participants, including study coordinator information, adverse reaction protocols, and 24/7 emergency support details.

Clinical Trial Participant Identity Verification Form

Clinical Trial Participant Identity Verification Form

Verify participant identity, eligibility, and collect essential medical information for clinical trial enrollment with integrated consent and screening.